Mediator: IgE antibodies
Onset: Less than 1hr (Rarely up to 72 hours)
Clinical Reaction: Anaphylaxis, urticaria, angioedema, hypotension, bronchospasm, stridor, pruritis
Anaphylaxis:
Penicillins: 0.015 – 0.2%
Cephalosporins: 0.0001 – 0.1%
Avoid the offending agent and side chain related agents
Mediator: IgG and IgM antibodies
Onset: Greater than 72 hours
Clinical Reaction: Hemolytic anemia, thrombocytopenia, neutropenia
Comments: Drug specific, avoid the offending agent
Mediator: IgG and IgM complexes
Onset: Greater than 72 hours
Clinical Reaction: Serum sickness, glomerulonephritis, small vessel vasculitis, drug fever
Comments: Antibody-antigen complexes precipitate in tissues and potentially affect any end organ
Mediator: T-Cells
Onset: Greater than 72 hours
Clinical Reaction: Contact dermatitis, pustulosis
Comments: Incidence is low
Mediator: Unknown
Onset: Usually greater than 72 hours
Clinical Reaction: Maculopapular or morbilliform rashes
Comments: 1 – 4% of patients receiving beta-lactams. Not a contraindication to future use of beta-lactam antibiotics
Defined as serious hypersensitivity reaction that is rapid in onset and may cause death, typically involving the skin, mucosal tissue or both and either respiratory compromise (e.g. dyspnea, wheeze-bronchospasm, stridor, reduced peak expiratory flow, hypoxemia) or reduced blood pressure or the associated symptoms and signs of end-organ dysfunction